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Objective: To establish family-centred health education for patients in a neurosurgery unit and to evaluate its impact on patients' and families' satisfaction. Design: Cooperative participatory research through which a group of clinical nurses and an academic researcher engaged in cycles of action and reflection. Setting: The study was conducted in a 26-bed neurosurgery unit in a university hospital located in a central province of Iran. Method: Parallel mixed methods were used to gather and analyse the data. Qualitative data regarding existing health education practice among nurses were collected using focus group discussions. Qualitative content analysis was used to identify problems in context. Quantitative analysis using "t" test (two tailed) was also done to compare the scores of patients and their families' satisfaction with the nurses' educational activities before and after implementing the agreed action plans. Results: Three main hindering factors including intra-professional, inter-professional, and institutional factors were recognized as barriers to establishing family-centred health education. The satisfaction scores of patients and families with the nurses' health education practices was significantly ("P" < 0.001) improved after performing the action phases. Conclusion: It seems that improvement in patients and their families' satisfaction indicated the success of the nurses in meeting health informational needs. Practical knowledge of health education practice was also enhanced through collaborative working.

Byline: Parsa. Yousefichaijan, Aziz. Eghbali, Mohammad. Rafeie, Mojtaba. Sharafkhah, Mohaddeseh. Zolfi, Mohammadreza. Firouzifar Background: Simple febrile convulsion is the most common disease of the nervous system in children. There are [...]

Background: Nephrolithiasis in children is associated with a high rate of complications and recurrence. Objectives:Since some evidences reported that zinc has an important place amongst inhibitors of crystallization and crystal growth, we decided to assess the effectiveness of oral zinc sulfate as adjuvant treatment in children with nephrolithiasis. Patients and Methods: This was a randomized, double-blind, placebo-controlled clinical trial. 102 children in the age range 1 month to 11 years with first nephrolithiasis were recruited. Patients were randomly divided into two equal groups (intervention and control groups). Intervention group received conservative measures for stones and 1 mg/kg/day (maximum 20 mg/day) oral zinc sulfate syrup for 3 months. Control group received placebo in addition to conservative measures, also for 3 months. Patients were followed up by ultrasonography for 9 months, in 5 steps (at the end of 1st, 2nd, 3rd, 6th and 9th month after treatment) assessing size and number of stones in the kidneys. Results: Only at the end of the first month, the average number (intervention: 1.15 ± 3.78, control: 1.3 ± 2.84) (P = 0.001) and size (cm) (intervention: 0.51 ± 1.76, control: 0.62 ± 1.39) (P = 0.001) of stones was significantly lower in the intervention group, and in other points there was no significant therapeutic efficacy in oral zinc adjuvant treatment compared to conservative treatment alone. Also, during the 9-month follow-up, the number and size of stones in both groups decreased significantly (both: P < 0.0001) in a way that the decrease in the intervention group showed no difference with the control group. Conclusions: Adjuvant treatment with zinc is not more effective than consecutive treatment in children with nephrolithiasis. However, further studies are recommended due to the lack of clinical evidence in this field. [ABSTRACT FROM AUTHOR]

Background: Diurnal voiding dysfunction is one of the most common causes of pediatric urology clinic admissions. It can cause behavioral problems for children and their parents. We lunch this study to compare the parents' function and children's behavior problem in pediatric patients suffering from diurnal voiding dysfunction referring Arak Amir Kabir hospital. Materials and Methods: To perform this case-control study, we recruit 116 children with diurnal voiding dysfunction and compared them with other 116 children non-affected children aged between 5 to 16 years old. The child behavior checklist (CBCL4/18) for children behavior assessment and Global Assessment of Functioning (GAF) for the evaluation of their parent's behavior was completed by the parents. Data was analyzed using ANOVA, qualitative variables and χ2 formula. Results: Among 116 patient with voiding dysfunction, 10 case (8.6%) showed behavioral problem while this figure was 3 case (2.6%) in the control group, denoting a significant difference (p=0.04). Moreover 20 children (17.2%) in the case group and 9 children (7.8%) in the control group had internalizing problem (p=0.02). Twenty two children (19%) with voiding dysfunction and 8 children (6.9%) in the healthy group had externalizing problem which was also a significant difference (p=0.01). As a significant difference (0.01), the parent's average stress and behavior scores in case and control group were 3.65 and 3.76, respectively. Conclusion: The higher prevalence of behavioral problem in the children suffering from diurnal voiding dysfunction and their parent's functional impairment highlights the importance of early parent's intervention for early treatment and subsequently prevention of future behavioral problem in their sibling. [ABSTRACT FROM AUTHOR]

Background: Simple febrile convulsion is the most common disease of the nervous system in children. There are hypotheses that iron deficiency may affect febrile convulsion and the threshold of neuron excitation. Aims: This study was conducted with the objective of finding the effects of iron deficiency anemia on simple febrile convulsion episodes. Settings and Design: The study was conducted at AmirKabir Hospital of Arak Medical Sciences University, Arak, Iran. This is a case-control study. Materials and Methods: In this study, 382 children who were selected according to our inclusion and exclusion factors, were divided into two groups of case (febrile convulsion) and control (other factors causing fever) by their cause of hospitalization. After fever subsided, 5 ml blood sample was taken from each child and complete blood count and iron profile tests were performed. Statistical Analysis: The results were interpreted using descriptive statistics and independent t-test. Results: The prevalence of anemia in the group with febrile convulsion was significantly less than that in the control group: 22.5% of the children in the group with febrile convulsion and 34% in the control group exhibited anemia (P < 0.001). Moreover, the group with febrile convulsion had significantly higher blood indices, such as Hb, Hct, MCV, MCH, and MCHC, compared to the control group (P < 0.001). Conclusions: Iron deficiency can prevent febrile convulsion in children and probably increases the threshold of neuron excitation in fever. [ABSTRACT FROM AUTHOR]

Background: Helicobacter pylori (H. pylori) is a global pathogen with a widely varied prevalence (30%-80%) among different countries and populations. This study aims to determine the prevalence of H. pylori in the population of Arak, Iran. Materials and Methods: This was an epidemiologic cross-sectional population-based study with multistage sampling. The population of Arak according to the 2006 census was 615,722 (493,845 urban and 121,857 rural residents). In this survey, five urban and four rural Health Service Centers were randomly selected. The study population was divided between these centers based on the population of individuals covered by these centers. Subsequently, clustered samples were randomly chosen according to Health Care Unit Family Codes and the Right Hand Rule. After obtaining informed consent and completion of a demographic questionnaire, 5 cc of venous blood was taken from each participant for the H. pylori IgG antibody test. In this study IgG antibody against H. pylori was measured by ELISA. Results: Of 1187 participants, 1150 (853 urban and 297 rural) completed the study. Overall, 673 (58.5%) were positive for H. pylori. The prevalence of H. pylori infection increased with age from 43.9% among those <20 years old to >70% in participants over 50 years old (p=0.002). A total of 57% urban samples and 63.3% rural samples were H. pylori positive (p=0.028). There was no relationship between H. pylori infection and education level (p=0.37), career (p=0.39) and income, (p=0.29) in either the urban or rural areas [p=0.64 (education level), 0.48 (career), and 0.57 (income)]. Conclusion: Our study showed a lower prevalence of H. pylori compared to some Asian countries, however this prevalence was more common than Western countries. Using disinfected tap water in both urban and rural areas in addition to improved access to general health care might have a role in this relative lower prevalence. [ABSTRACT FROM AUTHOR]

Introduction. Vitamin E is a fat-soluble vitamin that functions as an antioxidant. The aim of this study was to investigate the effects of vitamins E supplementation in combination with antibiotics for the treatment of girls with acute pyelonephritis. Materials and Methods. This double-blinded randomized controlled trial was conducted on 152 girls aged 5 to 12 years with a first acute pyelonephritis episode based on technetium Tc 99m dimercaptosuccinic acid (99mTc-DMSA). They were randomized to receive a 14-day treatment with only antibiotics (control group; n = 76) and 14-day treatment with supplements of vitamin E (intervention group; n = 76) in addition to the antibiotics. Patients'clinical symptoms were monitored for 14 days and urine culture was performed 3 to 4 days and 7 to 10 days after the start of the treatment and its completion, respectively. All of the girls once underwent DMSA scan 4 to 6 months after the treatment. Results. During the follow-up days, the mean frequency of fever (P = .01), urinary frequency (P = .001), urgency (P = .003), dribbling (P = .001), and urinary incontinence (P = .006) were significantly lower in the intervention group compared to the control group. There was no significant difference in the results of urine culture 3 to 4 days after the start of treatment (P = .16) and 7 to 10 days after its termination (P = .37). There was also no significant difference between the results of DMSA scan 4 to 6 months after the start of treatment (P = .31). Conclusions. Vitamin E supplementation has a significant effect in ameliorating sign and symptoms of UTI. However, further studies are recommended to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Congenital hypothyroidism (CH), as one of the most common congenital endocrine disorders, may be significantly associated with congenital malformations. This study investigates urogenital abnormalities in children with primary CH (PCH). Methods: This case-control study was conducted on 200 children aged three months to 1 year, referred to Amir-Kabir Hospital, Arak, Iran. One hundred children with PCH, as the case group, and 100 healthy children, as the control group, were selected using convenient sampling. For all children, demographic data checklists were filled, and physical examination, abdomen and pelvic ultrasound and other diagnostic measures (if necessary) were performed to evaluate the congenital urogenital abnormalities including anomalies of the penis and urethra, and disorders and anomalies of the scrotal contents. Results: Among 92 (100%) urogenital anomalies diagnosed, highest frequencies with 37 (40.2%), 26(28.2%) and 9 (9.7%) cases including hypospadias, Cryptorchidism, and hydrocele, respectively. The frequency of urogenital abnormalities among 32 children with PCH, with 52 cases (56.5%) was significantly higher than the frequency of abnormalities among the 21 children in the control group, with 40 cases (43.4%). (OR=2.04; 95%CI: 1.1-3.6; p=0.014). Conclusion: Our study demonstrated that PCH is significantly associated with the congenital urogenital abnormalities. However, due to the lack of evidence in this area, further studies are recommended to determine the necessity of conducting screening programs for abnormalities of the urogenital system in children with CH at birth.

Objective: To determine the diagnostic value of blood cells surface markers in patients with acute appendicitis., Methods: In this cross-sectional study, 71 patients who underwent appendectomy following a diagnosis of appendicitis were recruited during a one-year period. The patients were divided into two groups: patients with histopathologically confirmed acute appendicitis and subjects with normal appendix. Blood cell surface markers of all patients were measured. Univariate and multivariate analytical methods were applied to identify the most useful markers. Receiver operating characteristics (ROC) curves were also used to find the best cut-off point, sensitivity, and specificity., Results: Overall we included 71 patients with mean age of 22.6±10.7 years. Of the 71 cases, 45 (63.4%) had acute appendicitis while 26 (36.6%) were normal. There was no significant difference between two study groups regarding the age (p=0.151) and sex (p=0.142). The initial WBC count was significantly higher in those with acute appendicitis (p=0.033). Maximum and minimum area under the ROC curve in univariate analysis was reported for CD3/RA (0.71) and CD38 (0.533), respectively. Multivariate regression models revealed the percentage of accurate diagnoses based on the combination of γ/δ TCR, CD3/RO, and CD3/RA markers to be 74.65%. Maximum area under the ROC curve (0.79) was also obtained for the same combination., Conclusion: the best blood cell surface markers in the prediction of acute appendicitis were HLA-DR+CD19, a/β TCR, and CD3/RA. The simultaneous use of γ/δ TCR, CD3/RA, and CD3/RO showed the highest diagnostic value in acute appendicitis.